Archive for May, 2010

First clinic appointment after surgery

I really didn’t know what to expect from the first visit to the clinic after being dismissed from the hospital other than the redressing would be done. I really wasn’t looking forward to the ride back to MAMC either. Getting into the van was an ordeal, but the ride was short as I slept most of it. The gate ID check at Fort Lewis was funny as the gate guard couldn’t find the second person. My Husband had to tell him I was behind him in amongst the pillows. He laughed and passed us on through.

P7180028Once in the wheel chair, we headed to the Limb Preservation Clinic. I checked in, waited for the medic to ask his usual questions, take my blood pressure and show me to the room to wait for Dr. Roukis. He never kept me waiting and always tried to keep a pleasant atmosphere. Since I hadn’t slept well the night before, Max and I had watched a Russian film “The Cranes Are Flying”. A love story based around war. It had a sad ending as the girl goes to meet her love who is coming home, but he wasn’t there. He had been killed. Dr. Roukis poo-poohed the love story. Dr. Schweinberger, Alice and I, then, shared a moment at his expense.

Now, for the serious part of the appointment. Since I hadn’t seen P7180011any of what had been done to my foot, Dr. Roukis gave me an option. I could watch the entire process, or I could lay back and not watch. Of course I elected to watch. Dr. Roukis had taken pictures during some of my appointments to record my foot problems. I had brought my camera today. I asked him if I could take pictures. He said, “Are you planning a law suit?” My response, “Do I need to?” He then said, “Go ahead and take pictures”. I am so glad he did. It helped me in so many ways. Hopefully, now educating many about Charcot Foot and the process to save the foot.

Dr. Roukis took an hour to change the dressing, scrub the leg and foot, use the Betadine and repack the Orbital Fixator. His assistants did just that, assist by handing him betadine strips and anything else he needed. He used the strips to wrap the lower part of each P7180022wire, sliding the strip down the wire and pressing it firmly into the flesh. That was not comfortable and a bit painful. He wants NO INFECTION! In fact, he said, “You don’t even want an infection.”

Apparently, I must have had a strange look on my face as he asked me if I was okay? I was fine. I was fascinated with the wires going through my leg and foot and amazed at the lack of pain. The device was more awkward and heavy than painful. Dr. Roukis was pleased that there was very little swelling. These appointment were scheduled about two weeks apart. I would be in the Orbital Fixator for two to three months depending on the healing progress.

It was great to be able to leave the clinic feeling really positive.

Heading Home after Hospital stay

Max, my husband, decided he would be my caregiver. I was happy about this as I wasn’t excited about going to a care facility. I had visited friends there for rehabilitation and they didn’t seen very happy. Since the RV and the van were here and I was now unable to drive, he went to Silverdale to bring our son back to transport me home.

It was good to see Justin. Friends in my water aerobics class loaned me a wheel chair. After lunch on Friday and caring good-byes with thumbs up from staff, I was wheeled to the elevator and to the front of the hospital. The new venture of getting into a van for the ride home began. Max put pillows for me to lean against behind the drivers seat. I sat down on the back seat and began the slide. Using my left foot to help and my hands to lift my bottom in order to scoot. Max had to hold my right foot up. Once in place, the foot had to be elevated with more pillows. The seat belt clasps were very uncomfortable. We soon learned we needed to cover them and my sitting on a pillow made the sliding easier.

P7130151We drove to the RV where we left Max and our two kitties to head home. Yes, our kitties came along. Justin drove me. Our drive was about an hour and a half. Once home, we began the reverse, getting me out of the back seat and into the wheel chair. I couldn’t go into the main part of the house because of the stairs. The studio has a ground level entry so that would be our destination. It was so good to see the peacock hen that had come to live with us and all the other wild life around. The only real problem was getting into the studio. It was easier to turn the chair around and take me in backward over the threshold.

The hospital had sent lots of things home with me to make Max’s and my life easier; ice packs, special wash cloths and even wash caps for my hair. This was to be about three months with the Orbital Fixator. When it was to be removed there would be surgery on the toes.

It was good to be home and in my own bed, though after a while it wasn’t comfortable either. It was a very old mattress and as I said before, I’m not a back sleeper. So I was dozing off and on all day. I must admit I wasn’t sleeping very well at night. Since I love to talk, the phone was busy except when Max was on the computer in the room next door. I then used the cell phone. I had a stack of news papers I needed to sort so that became a task. Friends brought magazines, crossword puzzles, recorded programs, movies and other things to keep me busy. Everyone was so wonderful. I really enjoyed the many visits from friends and especially my “Pool Buddy” group. Flowers from friends and neighbors brightened my attitude and all of this helped with the recovery.Animals

I loved looking outside watching the deer as mom brought her twin fawns to show us, various birds especially the pea hen. She would come to the window near my bed and cock her head. I would talk with her. She would cluck or squawk as if to respond. ViVi, our Manx, even brought a kangaroo mouse in to entertain me. We thought we were going to have to learn to play “Dodge Mouse”, but she soon tired of the event and ate the creature. Dusty, our Burmese cat, stayed near at hand not understanding this entire scene.

Now for the first apointment after surgery.

“Ice Bag Duty” and going home

My new routine started the day of surgery. I was concerned Annita might have a very high glucose reading as she hadn’t had medication and that is not medically desired. I did not realize that the surgical team was keeping her glucose under control using insulin.

At about 1700 military usage, 5 pm to every one else, I went to the cafeteria for dinner. One unique thing about this hospital is its cafeteria. The food is really good. There is plenty of it at a price that’s very reasonable. Hospital cafeterias are not usually known to be Epicurean Palaces. At about 8 pm, I left the hospital to allow Annita to get as good a night’s sleep as was possible.

The following day and for many more thereafter, I left the RV around 7:30 at McChord AFB to drive the few miles to Madigan. I would go to Annita’s room to see how she was doing then go down and have breakfast. This allowed staff to do their morning routine. In addition to the Orbital Fixator, on Annita’s left leg was a device which gave her right leg muscles movement, similar to walking, done by inflating the deflating an air bag. P7100113The view from this room was outstanding, almost restful in a way. Mount Rainier was easily visible every day with differing amounts of cloud cover. Some times lightly tinted in pink, gray, or white depending on the levels of sun light. The water features around the hospital added to the restful effect. Rather than being bored while Annita slept, I read, watched TV some and helped in a small way by getting ice that was required to control swelling. She was to have an ice filled ice-bag placed above the right knee for 20 minutes out of each hour, 24/7, to help keep swelling down. They we very willing to show me where the crushed ice was located for “Ice Bag Duty.” By finding out where the ice was kept, I took care of the ice-bag requirement. I was not a hindrance, being thanked by a couple of the nurses. I left Madigan about 9 pm each day to drive back to the RV.

By the third day in the hospital room, Annita was well on her way to becoming acquainted with the medical staff assigned to her room. They were a good bunch, very willing to share humor and talk about places they had been and what it was like. They were a little surprised to learn we had gotten an entire six-pack of soda after she had been placed on the clear liquid diet. One nurse stated they could only get one can of soda at a time from the kitchen.

After 6 days, Dr. Roukis came in Thursday morning telling us he was going to release Annita the following day because of her recovery progress. I called Justin, our son, asking him to help me take Annita home the following day. In this way we would get us and the vehicles home in one trip. That evening I drove to Silverdale. I brought Justin back with me. The following morning we went to Madigan to await Annita’s release. Before we left, we loaded all the blankets and pillows brought from home to cushion Annita for her trip.

Not long before Annita was discharged, I went to the parking lot to get thePillpws:van van. It had to be brought very close to the side walk by the hospital entrance. Justin and I, with medic assistance got Annita “Inch Wormed” onto seats behind the driver. The difficulty was, she had to slide across two bucket style seats with seat belt connectors as P8220016obstacles. No roof straps or handles to grab, she had to lift and move herself where she could get purchase to do so. We held up her right foot and braced her left foot to assist. Annita worked, pushed, and wiggled her way in. Once properly on the seat with her legs stretched across the seats and her right leg elevated, we placed numerous pillows and blankets under her legs making for a more comfortable ride. She was seated with her back to the driver’s side. She had the ice-bag on her right leg. I’m sure she was very tired after getting all the way in.

After leaving MAMC, we stopped at McChord campground to get the RV. Then I followed Justin and Annita home. Once home, we used the borrowed wheel chair helping to maneuver Annita onto it. This was accomplished after she wiggled her way back across the seats, out of the van as we kept her right foot suspended. She hopped and slid her left foot turning about 90? keeping her balance so she could sit on the wheel chair. From there into the house was a snap, that is, until we came to the threshold of the doorway into the studio. Its was about 3 inches higher than the patio with a slight ramp so we had to back into the room. We got in all right only bouncing slightly.

This was the start of at home recovery. It was also the beginning of my new learning experience.

This weeks article was contributed by Max Shaw, husband of the founder of Charcot Awareness Education Foundation

Hospital Room After Surgery

Waking in my room at 4:30 PM was a surprise as it was so late. It was really good to see Max. Prior to the surgery, we were told to expect a two week stay. Since I am a diabetic, there was a concern about healing and keeping the blood sugar under control.

My medication was stopped prior to surgery. It was explained to me that they could control high blood sugar easier than low blood sugar as they could use insulin during surgery. I understood this, but during the hospital stay, it became an issue in no time. I was on the diabetic diet. I have been pretty conscience of how my body reacted to various foods. This diet was quite limited, but tolerable. I ordered my evening meal. Shortly after eating it, they gave me my regular meds. Within a half hour, they came in and took my blood reading. It was high. A young intern entered the room to give me an insulin shot. I refused it. She was upset as I explained I had been given my regular meds and they hadn’t had time to work. She came back with a supervisor. I explained everything to her. She asked if they could take a reading later. I had no problem with that. They left.

Several hours later, the night nurse came in. He took my blood reading. It was a bit high. I said I would take the insulin. He said I didn’t need it. I was surprised. Next morning, I had my normal reading back. I was really happy. The doctor in charge of internal medicine came in and wanted to monitor me very closely because of the happenings the day before. The morning I was released she came back to compliment me for keeping my blood sugar so well under control and knowing what worked for me.

Saturday, Dr. Roukis came in to see me. He explained things and told me he was going to take my pain medication away. I about panicked and asked what I should do if I needed them. He said he wasn’t taking them away totally, but that I had to ask for them if I needed them. Having never needed pain medication, I asked when would I know if I needed it. He said, “When you are in tears.” Fortunately, that never happened. I never did need them

Staff in roomEvery morning, I was awakened by Alice, an intern, who worked with Dr. Roukis and Dr. Sweinberger. She was delightful and will make a wonderful Doctor. The team really made the stay pleasant. Even those that took your blood were great. I loved hearing their stories. Many of them just back from Iraq. They always helped in any way they could.

On Wednesday, I began to vomit. No real reason for it, but I was promptly put on a clear liquid diet. Even the kitchen staff felt sorry for me when I called in my meal request. Talk about a limited diet. It was comprised, mainly, of clear broth and Sierra Mist Free. They did let me have a packet (table spoon size) of peanut butter handy if my blood sugar dropped too low.

My right foot and lower leg was in the Orbital Fixator. It was so P7070051 copyheavy. I could hardly move. My left was warped in a contraption that simulated muscle movement. I’m not a back sleeper so this was tough. There was a small TV near my bed. I left it on all the time, sleeping or watching TV, off and on all night. I had lots of time to think. The window in my room was very large and I had the best view in the world of Mt. Rainier. It was beautiful when the sun came up. Some mornings the clouds were a gentle pink in the sun rise. It gave me hope and started my day off beautifully.
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One thing I hadn’t expected was facing getting up out of bed and walking. When the physical therapist came in, he asked me to sit up, dangling my feet over the side of the bed. Not to bad. Then slide down putting my weight on my left foot and no weight on the right. WOW! What a sensation as the blood rushed creating a type of pain I had never experienced. The Orbital Fixator was heavy. My leg had been elevated the entire time and iced about every 20 minutes of an hour. I learned to hop on my left foot using a walker. He also gave me a number of exercises to do any time I could. These helped as I needed to build strength.

I was surprised when Dr. Roukis came in and told me I could go Menue:Bone Growthhome Friday, nearly a week early. Everything was going well. I was excited about leaving, but at the same time sad, as I didn’t want to say good-bye to such a wonderful group of people. When I called for my Friday noon meal, I asked if I was still on the clear liquid diet. She told me no, and that I could have anything on the menu. I asked if I could have a tuna sandwich. She said, “of course”. When I got it, it was huge, filled with about 4 times more tuna than usual. It tasted soooo good.

Note the bone growth stimulator on my foot. (above the menu) This was to help my body accept the artificial bone in my foot.

Now for the ride home.

Annita Shaw authored this weeks article